Solution focused brief therapy: a co-operative approach to work with clients

Abstract

Introduction In the early 1980s a team of therapists and researchers at the Brief Family Therapy Center in Milwaukee began exploring a new direction in brief therapy. What they discovered is best summed up in a statement from an early article: ‘Effective therapy can be done even when the therapist cannot describe what the client is complaining about. Basically, all the therapist and client need to know is “how will we know when the problem is solved?” ’ (de Shazer et ai, 1986). The tradition of brief therapy to which the Milwaukee group belonged was that of the Brief Therapy Center at the Mental Research Institute in Palo Alto (Watzlawick et al. , 1974). This earlier approach had pioneered a here and now approach to problem solving, based on the notion that ‘the attempted solution is the problem', in which it is assumed that problems arise when clients’ attempts to deal with everyday difficulties are unsuccessful but are nevertheless repeated in the vain hope of change occurring. For example, a person may be complaining about his or her partner's drinking, which leads to heavier drinking, which leads to more complaining, which leads … This approach is non-normative, in the sense that no attempt is made to categorise any person's behaviour as pathological. However, there is an emphasis on exploring what the clients have been doing to solve their problems, and for the therapist to design an intervention to help them do something different. It therefore came as something of a bombshell when Steve de Shazer and his team came upon the idea that to solve a problem it isn't even necessary to know what the problem is - and therefore, this is an approach that can be applied to a wide range of problem presentations. In this chapter we will describe the solution focused approach, and illustrate the ideas with reference to a clinical case. In keeping with the apparent transferability of this approach from problem to problem, we have not found it useful to make distinctions in the way we work with different substance usage. While clients experience their drug and alcohol usage in different ways, we have found that the approach to helping clients overcome their problems is essentially the same no matter what substance is being misused.